For Seniors, Poor Sleep May Mean Higher Stroke Risk, Study Suggests

Poor sleep may raise seniors’ risk of hardening of the brain arteries, and possibly contribute to the chances of a stroke, a new study suggests.

Researchers examined the autopsied brains of 315 people, average age 90, who had undergone at least one full week of sleep quality assessment before their death. Twenty-nine percent of them had suffered a stroke, and 61 percent had moderate-to-severe damage to blood vessels in the brain.

Those with the highest levels of sleep fragmentation — repeated awakenings or arousals — were 27 percent more likely to have hardening of the brain arteries. Among study participants, sleep was disrupted an average of nearly seven times an hour.

For each additional two arousals during one hour of sleep, there was a 30 percent greater likelihood of having visible signs of oxygen deprivation in the brain, the study authors said.

However, the study was not designed to prove a cause-and-effect link between poor sleep and stroke risk.

The findings were independent of other stroke and heart disease risk factors, such as weight, diabetes, smoking and high blood pressure, as well as other health conditions such as Alzheimer’s disease, depression, heart failure and pain, according to the study published Jan. 14 in the journal Stroke.

“The forms of brain injury that we observed are important because they may not only contribute to the risk of stroke but also to chronic progressive cognitive and motor impairment,” lead investigator Dr. Andrew Lim, an assistant professor of neurology at the University of Toronto, said in a journal news release.

“However, there are several ways to view these findings: sleep fragmentation may impair the circulation of blood to the brain, poor circulation of blood to the brain may cause sleep fragmentation, or both may be caused by another underlying risk factor,” said Lim, who is also a neurologist and scientist at Sunnybrook Health Sciences Center in Toronto.

While the findings suggest that sleep monitoring could help identify seniors at risk for stroke, further research is needed to clarify a number of areas.

One expert praised the research, but added that it wasn’t the last word on the topic.

“This is an excellent study, highly provocative, but not definitive because of the design, as mentioned by the authors themselves,” said Dr. Richard Libman, vice chairman of neurology at Long Island Jewish Medical Center in New Hyde Park, N.Y.

“There appears to be a clear association between poor sleep [sleep fragmentation] and hardening of the arteries and risk of stroke,” Libman said. “As noted, the direction of this association is uncertain.

“Sleep, to some degree, is within our control and we should all make attempts to improve the quality of our sleep,” he added.

How to Treat Heat Stroke

Heat stroke is a serious medical emergency, requiring aggressive cooling and immediate evacuation.

Things You'll Need

• Notebooks
• Sports drinks
• Pens
• Thermometers
• Water Filters
• Oral Rehydration Salts
• Rectal Thermometer
• Bandannas
• Coolers
• Ice
• Wilderness First Aid Classes
• Cold Compresses

Tips

1. Evaluate for heat stroke (see "How to Assess Heat Illness"). If you suspect heat stroke, treat with the following steps.

2. Move the patient out of direct sunlight, preferably into a cool, shaded area.

3. Have the patient lie flat and elevate his or her feet.

4. Remove heat-retaining clothing.

5. Wet the patient down and fan him or her, or immerse the patient in cool water.

6. Place ice packs on the patient's head, back of the neck, armpits, palms of the hands, soles of the feet and groin.

7. Hydrate well with lots of water, a diluted sports drink or oral rehydration solution, but only if the patient is conscious enough to hold a cup and drink unassisted.

8. Monitor body temperature frequently, keeping careful notes on how long the patient remains at a given temperature. Transfer these notes when you transfer care.

9. Evacuate immediately, continually monitoring and writing down the patient's body temperature.

How to Recover From a Stroke

When you or a loved one suffers a stroke, you want to do everything possible to assist recovery. A stroke is caused by an interruption or drastic reduction in the blood supply to part of the brain. When the blood can not flow to the brain, brain tissue is deprived of oxygen and nutrients, causing brain cells to die. Emergency medical treatment can lessen the extent of brain damage and disability. Today more Americans are surviving strokes than ever before and making successful recoveries. Ten percent of stroke survivors will make a full recovery. Forty percent suffer an impairment but go on to live full lives. The extent of the recovery varies based on amount of brain damage and the type of disability. Here is a guide to help you or your loved one make a successful recovery.

Things You'll Need

• Stroke rehabilitation program
• Recovery goals
• Nutritious well-balanced diet
• Tools for daily living
• Positive attitude
• Determination
• Family and friends

How to Recover from a Stroke

1. Participate in a stroke rehabilitation program. Rehabilitation programs are geared toward helping the stroke patient relearn skills lost due to the stroke. Programs include physical, speech, and occupational therapies so that patients can relearn any necessary movement or communication skills. Many of these programs begin at the hospital and then are continued in an another care facility. Getting involved in rehabilitation as early as possible makes a big difference in recovery.

2. Eat a healthy, well-balanced diet. A nutritious diet will help the body regain strength and promote healing. As you recover, you may find it hard to have the energy to cook regularly. Try to plan your meals ahead to make sure you are eating a nutritious diet. Eat the largest meal early in the day to help maintain energy. If you find you are not hungry enough to eat three normal size meals, try making six small meals daily. Ask friends and family to cook healthy meals for you that you can freeze them and eat at your convenience. You can also find programs that bring meals to seniors such as senior centers and "Meals on Wheels."Some stroke survivors will find eating a challenge if they have chewing or swallowing problems or problems holding utensils. For chewing and swallowing problems, you can try cutting food into smaller pieces before eating. Foods can also be blended into a smooth pudding to avoid choking. Special utensils and dishes developed for stroke survivors that feature larger handles, Velcro straps, or plate guards can make eating easier during recovery.

3. Obey the doctor's orders. Take all the prescribed medications and participate fully in the rehabilitation.

4. Set recovery goals. Work with your caregiver early during your recovery and develop a list of goals. The goals can be small or large. A half-smile is just as important as walking a few steps. Goals should include both skill recovery and activities desired after recovery, such as a trip to California. Prioritize the goals. Whenever a goal on the list is achieved, celebrate that victory. Celebrate both small and large victories. The list can be a great motivating tool.

5. Get all the necessary tools to assist your recovery. Besides rehabilitation, you want to make sure you have all that you need for daily activities. Have bathrooms and bedrooms converted to allow for wheelchair access and hand rails. Accept assistance from family, friends, or a cleaning service to keep your home clean and help do laundry. Follow the doctor's orders and use the cane or walker when you are too tired to walk on your own.

6. Accept help when you need assistance. Recovering from a stroke is a difficult emotional and physical journey. You may sometimes feel depressed or frustrated. Always talk to someone when you feel upset or discouraged. Consult a professional if you or your loved one shows signs of clinical depression.

7. Be determined to recover. Recovering lost skills after a stroke will be challenging and may take a while. Even if you must adjust to a permanent impairment, you can still live a full and satisfying life connected to loved ones and friends. Be determined to recover and do the things you enjoy.

8. Keep in touch with family and friends. Lean on the ones you love during this challenging time. They will help you stay determined and positive during recovery. They can lend a hand when you need assistance. Most of them will be happy to help you in any way possible.

9. Keep a positive attitude. Being hopeful and positive will make recovery from a stroke faster and easier. A positive attitude can lessen frustration and make coping with pain endurable. A positive attitude can also make the difference between a full or partial recovery.